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This rapid expert consultation provides guidance directed at mitigating morbidity and mortality associated with COVID-19, flu, and RSV this fall. This guidance addresses communicating with adults about the safety of the vaccines for these illnesses, the integration of the updated COVID-19 vaccines into ongoing public health efforts, and the effectiveness and safety of the new RSV vaccines.
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. 12 The CDC recommends that all persons aged 6 months and older receive annual flu vaccination and emphasizes vaccination of high-risk populations, such as adults aged 65 and older, adults with chronic health conditions, and pregnant people (CDC, 2020a)
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Challenges with vaccine uptake The low uptake of the 2022 bivalent COVID-19 booster and annual flu vaccines can be attributed to individuals' feelings and perceptions and to community factors such as social norms and issues of access. Demographic characteristics associated with vaccine uptake include age, engagement with biomedicine research, geographic location, health insurance coverage, political affiliation, race and ethnicity, religion, and socioeconomic status (Ashwell et al., 2021; Callaghan et al., 2021; Hussain et 18 Recently, the CDC adopted the Advisory Committee on Immunization Practices' (ACIP's)
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. A CDC study found that adults with insurance, a health care provider, and a recent medical checkup, for example, were more likely to receive flu vaccines than adults without these resources (Black et al., 2022)
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Communication Strategies for COVID-19, Flu, and RSV Vaccines The communication design principles set forth in previous National Academies rapid expert consultations -- Strategies for Building Confidence in the COVID-19 Vaccines; Understanding and Communicating About COVID-19 Vaccine Efficacy, Effectiveness, and Equity; and Communication Strategies for Building Confidence in COVID-19 Vaccines: Addressing Variants and Childhood Vaccinations -- still apply for the fall 2023 season. These strategies include providing authoritative evidence with transparency if uncertainties remain about vaccine safety and efficacy, testing messages to see how well they work, and improving the messages using feedback from the testing (NASEM, 2021a,b,c)
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. Communicate with Transparency and Openness According to a previous National Academies rapid expert consultation, "public engagement is critical to overcoming mistrust and building confidence," and it is "more likely to be impactful if the process is established and designed so that public values can be translated into practice and policy" (NASEM, 2021b, p.
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; and community nonprofits, such as the disability rights groups and immigration rights organizations in Wyoming that fostered trust between communities of color and state health officials to promote COVID-19 vaccination (LeBlanc et al., 24 Data from 10 states and New York City indicate an overall increase in flu vaccination of 9% during the last quarter of 2020 compared with the same time in 2018 and 2019, with adolescents, adults aged 18–64, and those aged 65 years or older receiving, respectively, 13%, 15%, and 9.5% more doses (Kuehn, 2021)
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Strategies for Overcoming Accessibility Challenges Effective communication alone is insufficient to increase vaccine uptake; the vaccines must be accessible to all individuals, regardless of socioeconomic, geographic, or demographic background. Historically, barriers to access have resulted in disparities in vaccine distribution and uptake.
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: • community engagement and education, • prioritizing of groups disproportionately impacted by illness and communities hit hardest by health disparities, • mobile vaccination units, • integrating vaccination with routine care (e.g., having flu vaccinations with routine antenatal care has been seen to increase vaccine uptake amongst pregnant people [Swamy & Heine, 2015]
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. A review of the effectiveness of interventions to improve uptake of the flu vaccine among pregnant people found that nudge-based interventions, such as provider prompts and standing orders, that build on favorable intentions to vaccinate were significantly successful in improving uptake (Ellingson et al., 2019)
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Collaboration with trusted community leaders and healthcare providers can foster vaccine confidence among marginalized populations, along with equitable vaccine distribution and uptake. SEAN is interested in your feedback.
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